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, <br /> ` eve�„ ' <br /> Q APPLICATION FOR RIGHT-OF-WAY USE PERMtT <br /> � i Type or print clearly with ink <br /> _� � PRESS HARD - YOU ARE MAKING COPIES <br /> PUBLIC WORKS <br /> EVERETT,WA:'�HI�'GTON PERMIT NO. <br /> �� / / � <br /> APPLICANT (UNOERSIGNED)AND FIRM REPRESENTED, IF ANY: �O�"�� YC'N J'✓2p �i,/Sr, �.0,_ <br /> HEREBY APPLIES FOR PERMISSION TO ��S�'�'// �'� / Cfl^�GZ� t-� �N`� �✓/1 y -- <br /> AT THE FOLLOWING IOCATION <br /> .�/ O 7 . . ..2,,3 �� �vF , i,tJ • <br /> DRAWING (dVORK TO BE DONE) OR THREE PLANS ATTACHED: <br /> ���• � � <br /> r�; '�. <br /> �,s,,� <br /> . <br /> I z � i.,� �- <br /> , <br /> Q �oNc. <br /> �i D�i�k:`.r <br /> �D • <br /> � <br /> a <br /> � <br /> I <br /> � <br /> I DRIVEWAY SECTION <br /> � <br /> j , PERMIT IS VALID FOR 60 DAYS � -----� <br /> COPY OF THI°, APPLICATION TO BE POSTED i" �IP <br /> � ON JOBSITE. �gp��_ � 30" <br /> j GALL F'OR INSPECTION 259-881 1 <br /> I 24 HOURS BEFORE CONSTRUCTION 7he undersigned ow��� hereby agrees to ho10 entl 5ave harmless <br /> the C�ty ol Everett imm any and ali claims lor tlamages, rosts. <br /> I eMpenses.or causes ot aclion iha�may arise because ol mstalla��on <br /> I antl rnamtenance ol t�e �mprovemenl o� other righl-of-way use <br /> I�e�efo a0�lie4 lor 0ntl Wriher agrCes Io re�nOve same u0�n not¢e <br /> Irom Ihe Ci�y an� to replaco pu01¢ pwperiy tlamdgetl I�ereby. <br /> I DEPARTMENT APPROVALS <br /> SEwE�� COMMUNiC/TiONS <br /> � E,Z,�� �. ��9ye z <br /> pR4WAGE TPAFRC <br /> /. _�--. <br /> I WATER PLNNNIN(. i SI AiUP F APPUCANi <br /> a/b iy 8i'—' 4✓ <br /> sinEE� aoonEss <br /> �/T� /� �i7��/,� E�mo..ios' __ 98vZo ' <br /> Cliv � : . 21P <br /> qPPR�-ED FOR CONSTRUC N oAr��� 7 7d ' 9��� 176 �70/ <br /> IELEanONE NVhIBER ' A�TERNATE <br /> L � �� � <br /> FPP V AS CONST CTED, OATE DAtE � . <br /> � CONSTRUCTION�AS 6UILT �EE 197B <br /> ---�,.,,_, _ .. <br /> � .��..�. . : <br /> �.,_... .,.._ _ , _ ..; � <br /> . -. . . . �. <br /> .. ♦.,> <br /> _ , . <br /> _ ._:, �. , . �. <br />